Twenty nine patients with rickets were studied in a one year period. The majority of patients (17/29) were below 2 years of age. Most of them had nutritional rickets resulting from a combination of factors. Premature delivery, nonexposure to sunlight, nutritional marasmus and inappropriate dietary intake. Some had familial hypophosphataemic rickets, others had renal tubular acidosis while the rest had rickets with a familial tendency. Both the previous hospital records and the present study indicate that rickets is a persistent problem in children in the community and should be suspected in children who present with features of failure to thrive, among other conditions.

Kenya Medical Research Institute, Clinical Research Centre, Nairobi. Twenty nine patients with rickets were studied in a one year period. The majority of patients (17/29) were below 2 years of age. Most of them had nutritional rickets resulting from a combination of factors. Premature delivery, nonexposure to sunlight, nutritional marasmus and inappropriate dietary intake. Some had familial hypophosphataemic rickets, others had renal tubular acidosis while the rest had rickets with a familial tendency. Both the previous hospital records and the present study indicate that rickets is a persistent problem in children in the community and should be suspected in children who present with features of failure to thrive, among other conditions. PMID: 7867549 [PubMed - indexed for MEDLINE]

Sudden death in the young after low energy anterior chest wall impact is an under-recognised phenomenon in this country. Review of the literature yields several American references to commotio cordis, mainly in the context of sporting events. Two cases are reported of sudden death in young men as a result of blunt impact anterior chest wall trauma. It is suggested that these cases draw attention to a lethal condition of which many practitioners are unaware.
J Accid Emerg Med 2000 Nov 17 (6): 421-422. PMID: 11104247 [PubMed - indexed for MEDLINE]PMCID: PMC1725482
 

Tala Quarrry in African Geoscience Review Vol. 9 Number 4 pp. 385-396.  

Tala Quarrry in African Geoscience Review Vol. 9 Number 4 pp. 385-396.  

Tala Quarrry in African Geoscience Review Vol. 9 Number 4 pp. 385-396.  

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One of the critical issues for Community Development, Civil Society action and Governance anywhere and specifically in Africa is to create leaders at the fastest possible rate, at all levels of the society/ community. Such levels of leadership revolve round - skilled, ethical, effective and unifying leadership. Young people are most eager to play a leadership role in these efforts. The values/ benefits of the African young people involvement in Civil Society in the African states will bring energy, catalyze other group members to rethink their priorities, commitment and remove invisible barriers that have kept them from moving forward. Typically and traditionally in many cultures, young people have been excluded from efforts to rebuild their communities. This marginalization of our youth not only harms them and endangers our future, but it also cheats the world of a valuable resource. If we are to function effectively as local and even global communities then we must incorporate all significant voices. This paper argues that an enduring and positive community renewal is possible only if all members are involved and feel a sense of ownership. On the other hand, the spirit of volunteerism by young people helps to create a stable and cohesive society and as a result add value to the services that governments provide. Voluntary action creates bonds of trust and encourages cooperation; in other words it creates social capital. Volunteerism draws people of different ethnic origins, religion and economic status. This compositional aspect enhances social harmony. Voluntary participation in public affairs can also help to create a politically literate public, which is important for the preservation of democratic principles. Volunteer effort is essential to Civil Society action as a way that would enhance community policing and conflict resolution. Service For Peace (SFP) Kenya Chapter as an organization, through its young people empowerment program has the aim to integrate service learning and volunteerism in the processes of capacity development/ building, creating appropriate awareness, dissemination and networking of the youth in the sub-regional and region areas. The Kenyan Chapter serves as a knowledge resource base for periodic value-based training programs on volunteerism.

A model for the establishment of a four-dimensional regional geodetic reference datum is presented. Starting from the three-dimensional integrated geodetic network model, formulations for the establishment of a four-dimensional regional datum are developed. Astronomic latitudes, astronomic longitudes, gravity values, gravity potential differences, gravity differences, and GPS-vectors are considered as observables. The estimated parameters defining the datura are point coordinates, deflections of the vertical and geoidai undulations, and velocities and accelerations on the positional coordinates. The network datum is considered observed over several epochs with parameters estimated from previous epochs being introduced into later epochs as stochastic prior information parameters.

Institute of Tropical Medicine, Antwerp, Belgium. The human immunodeficiency virus type 1 (HIV-1) DNA PCR results of 94 dried blood spot (DBS) samples on filter paper and corresponding venous blood in EDTA obtained from infants born to HIV-1-seropositive mothers were compared. In addition, the results of HIV-1 DNA PCR on DBS and the HIV-1 RNA PCR from plasma of 70 paired samples were compared. A 100% specificity and a 95% sensitivity for HIV-1 DNA PCR on DBS compared with results for venous blood were observed for the 94 paired samples. The results of the DBS HIV-1 DNA PCR and HIV-1 RNA PCR of 70 corresponding plasma samples correlated perfectly (100%). The DBS HIV-1 DNA PCR method proved reliable for HIV-1 detection.

Department of Periodontology/ Community and Preventive Dentistry, School of Dental Sciences, University of Nairobi, P.O. Box 19676 - 00202, Nairobi, Kenya. OBJECTIVE: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. DESIGN: Case control study. SETTING: Githongo sublocation in Meru District. SUBJECTS: Eighty five cases and 141 controls identified in a house-to-house screening. RESULTS: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing frequencies from the reference RR of 1.0 in those who brushed three times a day, to 7.6 in the "don't brush" group. The trend of increase was statistically significant (X2 for Trend : p = 0.001). The use of chewing stick as compared to conventional tooth brush had no significant influence on RR of oral leukoplakia. Non-users of toothpastes had a significantly higher risk of oral leukoplakia than users (RR = 1.8; 95% confidence levels (CI) = 1.4-2.5). Among tobacco smokers, the RR increased from 4.6 in those who brushed to 7.3 in those who did not brush. Among non-smokers, the RR of oral leukoplakia in those who did not brush (1.8) compared to those who brushed was also statistically significant (95% CL = 1.6-3.8). CONCLUSION: Failure to brush teeth and none use of toothpastes are significantly associated with the development of oral leukoplakia, while the choice of brushing tools between conventional toothbrush and chewing stick is not. In addition, failure to brush teeth appeared to potentiate the effect of smoking tobacco in the development of oral leukoplakia. Recommendations: Oral health education, instruction and motivation for the improvement of oral hygiene habits and practices; and therefore oral hygiene status, should be among the strategies used in oral leukoplakia preventive and control programmes.

BACKGROUND: Diabetic foot ulcers contribute significantly to the morbidity and mortality of patients with diabetes mellitus. The diabetic patients with foot ulcers require long hospitalisation and carry risk of limb amputation. The risk factors for developing diabetic foot ulcers are manageable. In Kenya there is paucity of data on such risk factors. OBJECTIVE: To determine the prevalence of diabetic foot ulcers and the risk factors in a clinic-based setting. DESIGN: Cross-sectional study. SETTING: Kenyatta National Hospital, Kenya. SUBJECTS: Patients with both type 1 and 2 diabetes mellitus who had active foot ulcers in both outpatient and inpatient units. MAIN OUTCOME MEASURES: Diabetic foot ulcers glycated haemoglobin, neuropathy, peripheral vascular disease and fasting lipid profile. RESULTS: One thousand seven hundred and eighty eight patients with diabetes mellitus were screened and 82 (4.6%) were found to have foot ulcers. The males and females with diabetic foot ulcers were compared in age, duration of foot ulcers, blood pressure, glycaemic control, neurological disability score and their proportion. Diabetic foot ulcers occurred mostly in patients who had had diabetes for a long duration. The types of (occurence) ulcers were neuropathic (47.5%), neuroischaemic (30.5%) and ischaemic (18%). The neuropathic ulcers had significantly poorer glycaemic control compared to other types and the longest duration (23.3 weeks). Ischaemic ulcers had significantly higher total cholesterol and diastolic blood pressure compared to other ulcer types. Wagner stage 2 ulcers were the commonest (49.4%) but stage 4 ulcers had their highest neuropathic score (7.8/10) and longest duration (23.6 weeks). Aerobic infective pathogens were isolated from 73.2% of the ulcers. CONCLUSION: The prevalence of diabetic foot ulcers was 4.6% in this tertiary clinic. The risk factors of diabetic foot ulcers in the study were poor glycaemic control, diastolic hypertension, dyslipidaemia, infection and poor self-care. These findings are similar to studies done in other environments and they are modifiable to achieve prevention, delay in formation or improved healing of foot ulcers in patients with diabetes. Therefore, specific attention should be paid to the management of these risk factors in patients with or without diabetes foot ulcers in this clinic.

OBJECTIVES: To evaluate the socio-demographic characteristics, chief complaints and clinical presentation of children attending a private dental clinic in Nairobi, Kenya. DESIGN: A retrospective survey of dental clinic records. SETTING: A private dental clinic in Nairobi, Kenya. SUBJECTS: All patients aged 0-18 years who were first-time attenders at the dental clinic during a three year period. RESULTS: The records of 800 patients were examined, comprising 395 males and 405 female children. The average age was 7.2 years (95%CI, 6.9-7.4). Referral to the clinic for treatment was mostly by self (81.4%). Most patients (57.9%) were self-sponsored for their dental treatment. Majority of the patients attending (86.8%) did not clinically have any underlying medical conditions. The major complaints for most patients were dental decay (27.4%) and dental pain (21.6%). Very few children (7.6%) attended for dental check-up. Five hundred and forty nine (68.6%) of the children suffered from dental decay while 294 (36.8%) suffered from gingivitis. The average number of teeth decayed was 4.02, SD +/- 2.4 (95% CI 3.8-4.2). Most carious lesions occurred in the younger children. There was a significant increase in the occurrence of decay over the three year period of the study. Significantly higher levels of gingivitis was observed in the prepubertal and pubertal age group. Attendance for traumatic injuries was relatively low with only 46 (5.8%) children reporting traumatic injuries to their dentitions. Most traumatic injuries involved the anterior teeth as a result of falls. Treatment given at the first visit was mainly restorative (28.6%) followed by dental extractions (25.4%). CONCLUSION: The average are of patients attending the clinic was 7.2 years. Interdisciplinary referral was low since most patients were self-referred and self sponsored for treatment. Dental caries was prevalent, necessitating a high demand for restorative treatment. Although gingivitis was less prevalent, it was significant among children in the prepubertal years.

While the role of logistics and supply chain management in developing competitive business capabilities is beginning to be recognized by many global organizations, there is critical need to ensure that training institutions do their part in imparting market-driven skills to prospective and existing practitioners. The role and importance of supply chain management has largely been attributed to the effects of globalization, intensifying competition and an increasing emphasis on customer orientation (Gunasekaran et al., 2004; Webster, 2002). Against this backdrop, effective supply chain management is considered key to building a sustainable competitive edge through improved inter and intra-firm relationships (Ellinger, 2000).

While the role of logistics and supply chain management in developing competitive business capabilities is beginning to be recognized by many global organizations, there is critical need to ensure that training institutions do their part in imparting market-driven skills to prospective and existing practitioners. The role and importance of supply chain management has largely been attributed to the effects of globalization, intensifying competition and an increasing emphasis on customer orientation (Gunasekaran et al., 2004; Webster, 2002). Against this backdrop, effective supply chain management is considered key to building a sustainable competitive edge through improved inter and intra-firm relationships (Ellinger, 2000).

While the role of logistics and supply chain management in developing competitive business capabilities is beginning to be recognized by many global organizations, there is critical need to ensure that training institutions do their part in imparting market-driven skills to prospective and existing practitioners. The role and importance of supply chain management has largely been attributed to the effects of globalization, intensifying competition and an increasing emphasis on customer orientation (Gunasekaran et al., 2004; Webster, 2002). Against this backdrop, effective supply chain management is considered key to building a sustainable competitive edge through improved inter and intra-firm relationships (Ellinger, 2000).

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The pathology of calves that died from experimental water intoxication was investigated. Oedema of the brain and urinary bladder, and renal damage were significant pathological findings in these calves. The findings were attributed to positive water balance in calves suffering from water intoxication

The pathology of calves that died from experimental water intoxication was investigated. Oedema of the brain and urinary bladder, and renal damage were significant pathological findings in these calves. The findings were attributed to positive water balance in calves suffering from water intoxication

 The  research evaluated clinical training provided by the academic institutions that offer Bachelor of Science in Nursing (BScN) program. The purpose of the study was to describe the adequacy of clinical training and the graduates preparedness for nursing practice. The study was conducted from Sept. 2008 to March 2010. Design was cross sectional using questionnaires and focus group interviews (FGI) methods to collect data. The sample comprised of 232 subjects including pre-service BScN graduates and nursing supervisors at four teaching and referral hospitals in Kenya. Results revealed that clinical training provided by academic institutions was adequate but quality of training varied widely among the training institutions. The conclusion was that clinical training provided by BScN programs in Kenya was of high quality. The study recommends that urgent attention was required by nurse educators to address identified gaps in clinical training especially clinical instruction and supervision.   

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

The gene Q13L coding for the Capripoxvirus group specific structural protein P32 was expressed in Escherichia coli using plasmid pGEX-2T as a fusion protein with glutathione-s-transferase and purified on glutathione sepharose affinity chromatography column. The protein was then employed for diagnosis of sheeppox, goatpox and lumpyskin disease, by a latex agglutination test (LAT) using the purified P32 antigen and guinea pig detector antiserum raised against the P32 antigen. The LAT and virus neutralization test (VNT) were used to screen one hundred livestock field sera for antibodies to Capripoxvirus, in comparison the LAT was simpler, rapid and 23% more sensitive than the VNT. In addition the LAT was found to be specific for Carpripoxvirus because it did not pick antibodies to Orthopoxvirus and Parapoxvirus. The LA test can be taken for a simple and quick diagnostic tool for primary screening of Carpripoxvirus infection and will reduce the reliance of diagnostic laboratories on tissue culture facilities. Keywords: Carpripox, latex agglutination test, attachment gene J. Trop. Microbiol. Biotechnol. Vol. 3 (2) 2007: pp. 36-43

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

This study set out to examine the policy position in Kenyan health care financing, with regard to implementation of the proposed social health scheme (NSHIF) and its performance potential. The specific objectives were to: examine the existing social scheme (NHIF), its role and challenges in health care financing; establish whether or not Kenya has the key pre-requisites for introduction and sustainability of a social health scheme and to provide recommendations on the way forward. This was largely a desk study, supplemented with limited primary data from key informants. The analysis indicates that: i) For a universal social health plan to be sustainable, favorable economic indicators and availability of essential infrastructures are critical prerequisites. Resources must be available, government must be in a position to afford high subsidies, the population must be ready to pay high premiums and the supply of health services must be adequate to cater for the expected increase in demand; ii) Countries that have successfully embraced social health plans introduced their schemes carefully and gradually (overtime) in terms of coverage; iii) Kenya compares unfavorably with these countries in terms of prerequisites for sustainability of a social health scheme, due largely to a poor economy, high poverty levels and shortfalls in facilities and services. The study concludes that Kenya lacks the key prerequisites for introducing and sustaining a universal social health scheme. The scheme can hardly be supported by the current status of the economy and healthcare infrastructures. The study recommends: i) Expansion and development of health care infrastructural capacities through subsidies and tax concessions for those investing in health care and providing subsidized services, particularly to the poor and rehabilitation of the GoK facilities; ii) Increasing the health budget from 7 per cent of government expenditure to above 10 per cent and directing more resources and efforts towards preventive/promotive and primary health care (P&PH); and iii) Other recommendations include subjecting the proposed scheme to an actuarial evaluation and comprehensive policy plan in order to determine the attendant and corresponding premium and benefit levels and pursuing a phased approach in the implementation of the scheme.

A retrospective study of the hospital records revealed that 39 cases of mandibular fractures presented at Kisii District Hospital during a two-year period. 27 cases were due to interpersonal violence while road traffic accidents and accidental falls accounted for 9 and 3 of the cases respectively. The male ratio was 2.9:1. Majority (26 cases) of the patients were aged between 20 and 39 years. The commonly involved fracture site was the left body of the mandible accounting for 20 of the fractures.

No abstract available. PMID: 6535699 [PubMed - indexed for MEDLINE]

Staphylococcus aureus strains were isolated from 183 of 300 raw milk samples collected at the Kenya Cooperative Creamery (Dandora). Ninety seven percent of the 183 strains isolated  were assayed for the production of enterotoxin A, B, C and D. Seventy two (74.2 %) of these were found to produce either a single or a combination of enterotoxins. Raw milk is a potential source of enterotoxigenic S. aureus in milk and milk products especially if there is defective pasteurization.

Staphylococcus aureus strains were isolated from 183 of 300 raw milk samples collected at the Kenya Cooperative Creamery (Dandora). Ninety seven percent of the 183 strains isolated  were assayed for the production of enterotoxin A, B, C and D. Seventy two (74.2 %) of these were found to produce either a single or a combination of enterotoxins. Raw milk is a potential source of enterotoxigenic S. aureus in milk and milk products especially if there is defective pasteurization.

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Twenty variceal banding sessions were performed in eight patients between February 1995 and September 1996. A total of 69 rings were used to band the varices and at each session between two to six rings were used. Two of the eight had active bleeding and both underwent variceal banding to successfully arrest their bleeding as inpatients. Sixteen other variceal banding sessions were performed on an outpatient basis to obliterate their varices. Four of the eight patients had had sclerotherapy before and varices were still present. No acute or long term complications were noted. In one patient, variceal banding could not be performed as he developed stridor upon placement of the overtube. All the patients had advanced varices (Grade III or IV) and extended for more than 15 cms in the oesophagus. Endoscopic variceal obliteration remains the treatment of choice for patients with portal hypertension with variceal bleeding. Variceal banding is associated with a superior outcome when compared with sclerotherapy; the variceal kill time is shorter, infective complications less, rebleeding occurs less commonly and transfusion requirements are lower.

This book addresses a wide array of issues in botany through a series of chapters. The chapters have been contributed by leading botanists from South America, Africa, Europe and

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Vaccination of five baboons with an anti-idiotypic vaccine to irradiated Schistosoma mansoni cercariae resulted in nearly 19% protection compared to 39% protection conferred to five baboons vaccinated with an irradiated vaccine. Vaccination with the anti-idiotypic antibodies resulted in a significant reduction of pathology and granuloma size following challenge with live unattenuated cercariae. Results presented in this work are considered highly significant because the anti-idiotypic vaccine markedly influenced schistosomiasis morbidity which is the main consideration in this disease.

Although a relationship between Lapiat and post-Lapita ceramic traditions has long been suspected, a systematic and detailed examination of the similarities and differences has not been previously made. An important first step is to determine the nature of change from one to the other by examining pottery from sites which have the full ceramic sequence. My analyses of the assemblages from Manus and New Island demonstrate continuity between the two traditions.

Although a relationship between Lapiat and post-Lapita ceramic traditions has long been suspected, a systematic and detailed examination of the similarities and differences has not been previously made. An important first step is to determine the nature of change from one to the other by examining pottery from sites which have the full ceramic sequence. My analyses of the assemblages from Manus and New Island demonstrate continuity between the two traditions.

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Department of Dental Surgery, Kenyatta National Hospital, Nairobi. A survey of 904, 14-17 year old school children from secondary schools around Nairobi was done to find out if there was any relationship between toothbrushing frequency and personal hygiene habits. The students completed a questionnaire anonymously in class. Female students brushed their teeth more often than the male students. 62.2% of the females and 50.1% of the males brushed their teeth more than once a day. Of those students who brushed their teeth more than once a day, 52% bathed daily, 22% used perfumes/deodorants daily and 50.1% always washed their hands after visiting the lavatory. No relationship was found between washing of hair and toothbrushing frequency. 69.7% males and 53.2% females gave toothache and tooth decay as the main reasons for mouth care. Those who brushed their teeth more frequently also visited the medical doctor regularly for routine check-ups. These findings indicated that toothbrushing was closely related to personal hygiene habits.

Ethnopharmacological relevance: Traditional medicines play an important role in the management of chronically painful and debilitating joint conditions, particularly in the rural Africa. However, their potential use as sources of medicines has not been fully exploited. The present study was carried to find the medicinal plants traditionally used to manage chronic joint pains in Machakos and Makueni counties in Kenya. Materials and methods: To obtain this ethnobotanical information, 30 consenting traditional herbal med-ical practitioners were interviewed exclusively on medicinal plant use in the management of chronic joint pains, in a pre-planned workshop. Results and discussion: In this survey, a total of 37 plants belonging to 32 genera and 23 families were cited as being important for treatment of chronic joint pains. The most commonly cited plant species were Pavetta crassipes K. Schum, Strychnos henningsii Gilg., Carissa spinarum L., Fagaropsis hildebrandtii (Engl.) Milve-Redh. and Zanthoxylum chalybeum Engl. Acacia mellifera (Vahl) Benth., Amaranthus albus L., Balanites glabra Mildbr. & Schltr., Grewia fallax K. Schum., Lactuca capensis, Launaea cornuta (Oliv. & Hiern) O. Jeffrey, Lippia kituiensis Vatke, Pappea capensis Eckl. & Zeyh. and Pennisetum glaucum (L.) R. Br. are documented for the first time as being important in the management of chronic joint pains. Conclusions: The findings of this study show that a variety of medicinal plants are used in the management of chronic joint pains and the main mode of administration is oral. Keywords: Ethnobotanical survey; Medicinal plants; Chronic joint pains; Rheumatoid arthritis; Akamba; Machakos-Kenya

Staphylococcus aureus strains were isolated from 183 of 300 raw milk samples collected at the Kenya Cooperative Creamery (Dandora). Ninety seven percent of the 183 strains isolated  were assayed for the production of enterotoxin A, B, C and D. Seventy two (74.2 %) of these were found to produce either a single or a combination of enterotoxins. Raw milk is a potential source of enterotoxigenic S. aureus in milk and milk products especially if there is defective pasteurization.

Staphylococcus aureus strains were isolated from 183 of 300 raw milk samples collected at the Kenya Cooperative Creamery (Dandora). Ninety seven percent of the 183 strains isolated  were assayed for the production of enterotoxin A, B, C and D. Seventy two (74.2 %) of these were found to produce either a single or a combination of enterotoxins. Raw milk is a potential source of enterotoxigenic S. aureus in milk and milk products especially if there is defective pasteurization.

Staphylococcus aureus strains were isolated from 183 of 300 raw milk samples collected at the Kenya Cooperative Creamery (Dandora). Ninety seven percent of the 183 strains isolated  were assayed for the production of enterotoxin A, B, C and D. Seventy two (74.2 %) of these were found to produce either a single or a combination of enterotoxins. Raw milk is a potential source of enterotoxigenic S. aureus in milk and milk products especially if there is defective pasteurization.